As is well known by those skilled in the medical technology, knot tying of sutures when done in a medical procedure, as for example, when tying tissue to the bone, is deemed to be one of the weakest links in the procedure being performed by the surgeon. This is the case whether the procedure is arthroscopic or a partial or full opening of the area being repaired. It is well known in this technology that no two arthroscopic knots on the suture that are made by surgeons are the same and equally known is that a well known problem is that the surgeon cannot tie the knot in such a manner that the securing of the tissue to the bone is at its optimum. In other words, the tissue when tied down does not hug or cling to the bone as well as it could.
While this invention has been conceived in addressing rotator cuff tears with the purpose of obtaining a suture that solves the knot problem that is alluded to in the above paragraph, it will become obvious in the description of this invention that follows, that the inventive instrument can be utilized in other surgical procedures. The rotator cuff tear is quite common and because of the difficulty of tying the tissue to the bone this has presented an ever increasing problem to the surgeon. The rotator cuff is a group of muscles that attach, through their tendons, to the top of the upper arm bone (humerus). A tear in these tissues often require surgery to repair the tear. The options left to the surgeon, depending on the severity of the tear, is either an arthroscopic repair, a mini-open repair that combines arthroscopy and a small incision or open surgery. Whatever the procedure, the tissue is ultimately tied to the bone and often by use of an anchor that is secured into the bone and a suture that is tied to the tissue and anchor and then knotted. This invention is directed to a unique apparatus that secures the tissue to the bone and is judiciously adjusted so that the tissue is tied to the bone cinching to the bone as closely as is possible. Hence, this invention relates to an instrument that is used for tying tissue to the bone and to an instrument that automatically secures the suture and to the method for permitting the surgeon to manipulate the suture when utilizing this inventive apparatus in such a manner that the tissue will be cinched to the bone as close as it possibly can.
This instrument and method of shoulder repair is entirely different from the AutoCuff System made by Opus Medical which utilizes the SmartStitch Suturing Device and the Magnum Knotless Fixation Implant. This suturing device eliminates the knot tying by using a mechanized mattress stitch. The device places the stitch directly into the tissue. Once the stitch is placed in the cuff, the surgeon loads and deploys the Magnum Knotless Implant. This procedure is distinguishable from the present invention.